O uso do canabidiol como terapia alternativa no tratamento da epilepsia com ênfase na infância: uma revisão integrativa

Abstract

Introduction: Epilepsy is a syndrome characterized by recurrent and spontaneous seizures (SRCs), which may have behavioral manifestations such as involuntary movements that can vary in intensity, repetition and duration. The occurrence of childhood epilepsy is inconsistent, with varying rates. Patients diagnosed with epilepsy usually have more severe seizures in the first years of life, which may compromise their development and quality of life. It is important to emphasize that the types of epilepsy that affect children have a high refractoriness rate, which encourages several research groups to search for alternative therapies. In this scenario, the use of cannabidiol (CBD), a substance obtained from Cannabis sativa, has been the subject of studies by research groups, as it has several medicinal properties. Objective: to carry out an integrative review of studies published between 2016 and 2022, in order to analyze the use of CBD as an alternative therapy to anticonvulsant treatment in patients with epilepsy, with emphasis on childhood. Methods: We opted for an integrative review with synthetic and critical analysis. The research survey was carried out in the following databases: Pubmed, Google Scholar, Crochane, SciELo and Lilacs. Studies and articles that addressed the theme were selected, following previously elaborated descriptors and according to the pre-set inclusion and exclusion criteria, both for the synthetic analysis and for the critical analysis. Results: most of the studies selected for critical analysis were found in the Pubmed database. The articles and other bibliographical references selected to serve as a basis for the synthetic analysis of this research were satisfactory. In 50% of the studies found, cannabidiol, used as an anticonvulsant treatment, had a result ≥ 50% for the reduction of epileptic seizures. In 75%, adverse effects were found, ranging from diarrhea, drowsiness and vomiting to elevated concentrations of liver aminotransferases. And 50% of the selected studies pointed to the need for further research to confirm the efficacy and safety of using cannabidiol, as well as its standardization. General considerations: the results of studies have shown that treatment with cannabidiol, especially for childhood epilepsy, reduces the frequency of seizures, but is more effective in cases of Dravet Syndrome (DS) and LenoxGastau Syndrome (SLG). Some studies point to moderate to severe adverse reactions, which reduces the risk-benefit safety for other types of epilepsy. So far, it has not been possible to establish a standardization in the treatment of epilepsy with CBD, which indicates the need for further studies. Therefore, there is still no robust evidence regarding the safety, efficacy and standardization of the therapeutic use of CBD for the treatment of epilepsy.